Abstract

Total body irradiation and pneumonitis risk: a review of outcomes SA Carruthers*,1 and MM Wallington2 1Department of Radiation Oncology, Royal Adelaide Hospital Cancer Centre, North Terrace, Adelaide, South Australia 5000, Australia; 2Department of Radiation Oncology, Royal Hobart Hospital, The University of Tasmania, Hobart, Tasmania 7000, Australia A review was undertaken of all patients treated at Royal Adelaide Hospital, South Australia with total body irradiation (TBI) for the purpose of assessing the incidence of interstitial pneumonitis (IP) and possible prognostic factors for its development. The aim was also to assess the impact of IP and other prognostic factors on long-term survival outcome following bone marrow transplantation. A total of 84 patients received TBI, with 12 Gy in six fractions delivered using two different instantaneous dose rates of 7.5 and 15 cGy min�1. This series included 26 cases of acute lymphoblastic leukaemia, 26 of multiple myeloma and 15 of acute myelogenous leukaemia. On multivariate analysis, a higher dose rate was independently significant for an increased risk of IP. British Journal of Cancer (2004) 90, 2080–2084. doi:10.1038/sj.bjc.6601751 www.bjcancer.com & 2004 Cancer Research UK Published online 4 May 2004 Keywords: total body irradiation; interstitial pneumonitis � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � Total body irradiation (TBI) is frequently used for conditioning prior to allogeneic bone marrow transplantation (BMT) due to its immunosuppressive effect on the host immune system, thus minimising the risk of engraftment failure (Torres et al, 1982; Cardozo et al, 1985; Kader et al, 1994). This role has been used principally in acute myelogenous leukaemia (AML) and acute lymphoblastic leukaemia (ALL). In addition to aiding engraftment, TBI provides additional malignant cell kill and is active in chemotherapy inaccessible sanctuary sites. These latter functions are the predominant rationale for the use of TBI

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